2015 Westview Band

Percussion Camp

Camper Name: ____________________________________________________ Grade in Fall 2015: __________

Parent/Guardian Name(s): ______________________________________________________________________
Address: ____________________________________________________________________________________
Telephone: (

) _________________________ E-Mail: _____________________________________________

Emergency Contact Name: _____________________________________________________________________

Emergency Contact Phone Numbers: _____________________________________________________________
Health Insurance Company: ______________________________ Policy Number: __________________________
Please list any health/medical issues we should know about (allergies, medications, etc.): ____________________
___________________________________________________________________________________________

Percussion Camp Fee: $50 per camper, payable to Westview Band

Percussion Camp Specifics:
Westview High School, north parking lot by the cluster of portable classrooms
Mon. & Tues., June 15 & 16, 2015
8 a.m. to 5 p.m. each day

Who Can Attend?

Students who will attend Westview High School in Fall 2015
Students living in the Westview High School attendance area who will enter grades 9-12 in Fall 2015
No experience necessary!

What to Bring:
Water bottle, lunch and snacks
Sunscreen (well be outside most of the day)
Wear comfortable, athletic clothing in which you can move easily (shorts, t-shirt, etc.)
Drumsticks and practice pad (if you have them
3-ring binder with sheet protectors

Medical Treatment Consent & Liability Release

I hereby authorize the Westview Band Percussion & Colorguard Camp directors and the camp staff to act for me
according to their best judgment in any emergency situation requiring medical attention and hereby waive and
release the Beaverton School District, Westview High School, Westview Band & Auxiliary Parent Organization, Inc.,
the camp director and camp staff from any and all liability resulting from injuries or illness incurred by the above
mentioned camper while at this camp.

Parent/Guardian Signature __________________________________________ Date ________________